Postoperative cognitive dysfunction (POCD), defined as a decline in cognitive performance after surgery as compared to preoperative baseline, has recently emerged as a growing concern in the aging surgical population because of the associated consequences, cost and lack of mechanism-based interventions.1,2 

The growing interest in POCD has only been matched by the growing controversy about the mechanisms underlying POCD and the risk factors predisposing to development of POCD. This is especially true when considering the proposed role of anesthetic agents in the development of POCD.2-9  Some of this controversy is due to the challenges of interpreting research findings since many of the studies are small and differ with regard to the timing and methods used to assess preoperative baseline and postoperative cognition as well as in the definition of POCD.10  Adding to...

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